Provider Demographics
NPI:1346575438
Name:WORLEY, MAUREEN MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:MARIE
Last Name:WORLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SHORE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:CT
Mailing Address - Zip Code:06413-2311
Mailing Address - Country:US
Mailing Address - Phone:860-888-8045
Mailing Address - Fax:
Practice Address - Street 1:129 PATRICIA M GENOVA DR
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-1543
Practice Address - Country:US
Practice Address - Phone:860-888-8045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-07
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPENDING363LF0000X
CT4226363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily